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New guidelines for the treatment of perineal tears is set to improve care for women during childbirth.


The Third and Fourth Degree Perineal Tears Clinical Care Standard, released by Australian Commission on Safety and Quality in Healthcare, aims to address the geographical variance reported among women who experience third or fourth degree perineal tears during childbirth.

Drawing on statistics from the Second Australian Atlas of Healthcare Variation across 2012-14, it was found during 2012-14 that while in some regions 6 in 1000 women were experiencing a third or fourth degree perineal tear during child birth, in other Australian regions, the figures were as high as 71 in 1000.

Additionally, more recent data from 2017 showed Australian women experienced perineal tears at a rate higher than that of the similarly placed countries in the OECD.

In light of the data, Professor Anne Duggan, the Commission’s Clinical Director, said it was crucial that the new guidelines be used to increase the communication and transparency between women and health care professionals.

“Making sure that women get the information they need before they go into labour is one thing we can do to improve the quality of care we offer to mothers, particularly in relation to perineal tearing where we don’t do as well as comparable countries in the OECD,” Professor Duggan said.

“The new standard will also improve the care, and ensure the best chance of recovery, for women who do experience such tears. When they occur, it is important that they are identified early and are surgically repaired soon after birth to help prevent long-term problems.”

With the new standards endorsed by both the Australian College of Midwives and the Royal Australian and New Zealand College of Obsetricians and Gynaecologists, Western Sydney University Professor of Midwifery, Hannah Dahlen AM, said she was glad to see a serious engagement with the issue of perineal trauma.

“I am so pleased to see this important area of women’s health being given the considered attention that it needs with the release of a national standard of care to support both women and healthcare professionals working in maternity care,” she said.

“We need healthcare providers to talk to women sensitively about this important health issue during pregnancy, so they can be empowered with knowledge and helpful strategies as they approach one of the most powerful moments of their lives.”

More information on the new standards can be found at the Australian Commission on Safety and Quality in Healthcare website, while a live-stream featuring both Professors Duggan and Dahlen, alongside other speakers, will also be viewable from here.